Transpersonal Thanatology

Transpersonal Psychology represents what has been called a fourth force in the movements of psychology (Chinen, 1996). In an attempt to counterbalance the two movements of the 1960s, psychoanalysis and behaviorism, a third force was born to focus psychology on more positive health oriented concerns rather than pathology and stimulus response (Chinen, 1996). This third force was the humanistic movement, which dealt with the human potential, psychological health and personal happiness. What this force was missing sparked Anthony Sutich, then founder and editor of the Journal of Humanistic Psychology, to begin holding meetings in his home to discuss topics that moved beyond mere psychological health and slipped unapologetically into the realm of mysticism and the spirit (Chinen, 1996).

From these meetings was born the above mentioned fourth force, transpersonal psychiatry and psychology. Bruce Scotton (1996) defines transpersonal psychiatry as;
"…psychiatry that seeks to foster development, correct developmental arrests, and heal traumas at all levels of development, including transpersonal levels. It extends the standard biopsychosocial model of psychiatry to a biopsychosocial-spiritual one in which the later stages of human development are concerned with development beyond, or transcendent of, the individual." (p. 4)

While humanistic psychology deals amicably with the individual and problems of the individual Self Transpersonal Psychology takes this a step beyond and deals with higher levels of human individuality, namely that of transcendence of individuality and the ego.

Psychoanalytic theory seems to have had a difficult time dealing with death as it relates to the phenomena that individuals will ultimately confront. While it does not seem to have dealt with the issue directly, it appears from Razinsky in his commentary on Freud’s essay “Thoughts for the Times on War and Death” that Freud himself did deal with the issue and was, as is common for Freud’s work, misunderstood. In the first instance, Razinsky cites several authors who argue that Freud’s view of death was reductionistic. To support the claim of reductionism he states Freud’s position was that fear of death stemmed from a separation anxiety. However, it is reductionist to take this statement and not consider it more deeply. What more could there be to fear of death? In the end, we ultimately develop ourselves based on our superegos. We spend our days defining ourselves by our consciousness, by our cultures, and by what we own. In fact much has been shown experimentally in terror management theory to support the idea that when we are confronted with our own mortality, we tend to cling more tightly to the things of our culture (Solomon, 1991). If we cling more tightly, this could indicate that we fear losing these things. This is in effect separation anxiety and there is very little reduction involved. These are very deep concerns of the individual psyche that must be dealt with in the face of death.
Razinsky points out two positions held by Freud concerning death, and claims that Freud’s problem is that he holds them simultaneously. This is simply not the case. It speaks well of Freud that he was able to do hold these two positions. The positions, as explained by Razinsky are: 1) We do not think about death because we do not want to; and, 2) that we cannot think about death. Both of these positions, in essence, are correct and not as contradictory as they may seem at first glance. Thinking too deeply on death for too long can lead to one of two outcomes. The individual can become crippled with fear and fall into obsessive attempts to avoid death or the individual can enter into a state of meditative realization, much like is described through the Bardo Thodal. In the Bardo Thodal, or the Tibetan Book of the Dead, the individual, through a series of deep meditations on the archetypes of the realm of death, ultimately is freed from the fear of death and prepared for the journey into the unknown (Evans-Wentz, 1960). We can see in this the use of thinking deeply on the subject, death, as an aid in ultimately freeing ourselves from the need to think about death, or at least the fear involved in its contemplation. Death is a complete unknown. The only thing we can truly contemplate concerning death is the process of dying, not death itself. Freud was not off the mark in his two positions; he was merely accepting two of the truths concerning death.

Whether there is an inability or an unwillingness to think about death is inconsequential to the dying. The dying not only think about death but are living out the process of death. While Freud may or may not have dealt with death in a psychoanalytical light, the reality of death could never be unearthed in an analyst’s chair the way it is with those who are undergoing the actual process of dying and those who are giving care to the dying.

Ego transcendence has been a primary concern in eastern religions such as Buddhism, Taoism, and Hinduism for thousands of years. Transpersonal psychology may very well represent the first time that ego transcendence has been taken seriously by academic circles in the West. The psychoanalysis of Freud was strongly grounded in theories of the ego and worked within this framework to heal the ego of the individual, or at least to allow for smoother functioning of the ego. Behaviorism ignored these ideas all together and looked at the human as a series of reactions to stimuli. Humanistic psychology looked at the individual as separate from the larger whole and focused on healing from this level. Transpersonal psychology looks at the experiences of the Buddhist, Taoist and Hindu, and considers the spiritual realm from which these levels of human functioning are being experienced.

Transcendence in Eastern philosophy and spirituality is viewed not only from the view that the True Self, or the essence of Self, is separating from the ego self, but a moment in which this True Self is united with a larger whole. Through certain yogic practices, meditation, and trance states the self or ego is transcended and the individual becomes united with the Self. The most notable moment of transcendence, the ultimate separation from the ego, can be seen as death. Death represents a separation of the individual from the biopsychosocial forms of being and entry into a realm that cannot be quantified or looked at through the lenses of empirical science. In this respect the only field of psychology equipped to deal with this aspect of the human experience is transpersonal psychology.

In the three primary religions of the East namely Hinduism, Taoism and Buddhism the function of transcendence is paramount. This transcendence is not only vital to proper death experience but is a goal of daily living as well. In achieving transcendence, which is perhaps synonymous with enlightenment in this case, the individual comes to a place in which death does not represent an end nor a separation. Death may in fact represent the fulfillment of an ultimate unity that the practitioner of transcendent methodologies has been cultivating throughout life.
In the Bhagavad Gita Sri Krishna explains to Arjuna how to die. One of the primary goals in Hinduism, living a good life, involves ending the cycle of samsara, or rebirth, that one may be united with the Lord in eternal peace. This peace involves not so much a consciousness afterlife as much as it does a single pointed knowing that is the goal of the meditations and yoga practiced by the Hindi. Krishna goes on to explain that what occupies the mind of the dying at the moment of death “determines the destination of the dying” (Bhagavad Gita, 8:6). It is vital, Krishna teaches, that the dying hold to the single pointed concentration learned during meditation to insure that the adhidaiva (eternal spirit) is absorbed into the unity of Krishna and not cycled back toward rebirth. The instruction given involves placing the mind at the heart during the moment of death. Here the heart may be correlated to the heart chakra (Bhagavad Gita, p.121). With this done and all thoughts on Krishna, the dying is instructed to push one’s energy up toward the top of the head while chanting the Sanskrit syllable “Om”. Krishna defines the meaning of this chanted syllable as “the changeless Brahman” (8:13), which is the Hindu concept of the ultimate energy that permeates and is indeed all things. This energy can be channeled, in a sense summoned, by the chanting of the syllable. With this chanting in progress and the adhidaiva pushed through the top of the head, Krishna indicates that the individual my leave the body and “attain the supreme goal” (8:13). The pushing of the energy through the top of the head may very well be intimating the Crown Chakra or Sahasrāra. This chakra has been described as starting out as a depression in the chakra system, much like that of a bowl. Only as the practitioner of yoga and meditation advances does this Chakra turn out forming the thousand pedaled lotus of the enlightened ones (Leadbeater, 1927). Also called the Crown Chakra, Leadbeater continues the analogy by drawing attention to the historical use of the Crown Chakra in Christian art where it is more often referred to as a halo. This symbolism and its use in the Bhagavad Gita draws attention to the need of the individual to become enlightened or “actualized” before death. Krishna himself reminds Arjuna what the meaning of the Lord is and how union with this Lord may be attained “This supreme Lord who pervades all existence, the true Self of all creatures, may be realized through undivided love.” (8:22)

In the Teaching of Buddha, the Buddha relays a story concerning the death of a child and the mourning mother. The mother who finds her child dead becomes obsessed with bringing her child back to life. She goes from house to house begging for someone to heal her child. Eventually she makes it to the Buddha who tells her that he will need three poppy seeds in order to heal her child. He further instructs the women that these seeds must come from a home in which death has never entered. Unable to find such a home, she returns to the Buddha and suddenly understands what he has taught her. Through this, we see the Buddhist’s accepting attitude of death, and the realization of its inevitability (The Teaching of Buddha, 3:5).

Within Buddhism there is a single text dedicated solely to the dead, dying and the bereaved: The Bardo Thodal or The Tibetan Book of the Dead. This text reads as a guide to the dead giving them one last chance to come to full realization and end the cycle of rebirth, to become one with Buddha nature. If the dead has begun the process described in the Bardo it is the person’s ill Karma or his or her attachment to the world of the living that has lead them to this level.
The guru begins to read to the dead thus, “O nobly-born, whatever fearful and terrifying visions thou mayst see, recognize them to be thine own thought-forms” (Evans-Wentz, 1960, p.147). From this point forward it is explained to the dead that he or she should meditate upon the precious trinity. If the deceased does not know how to do this it is explained that the Lhan-chig-skyes-pahi-lha (simultaneously born god) shall come before them along with the Lhan-chig-skyes-pahi-hdre (simultaneously born demon). It is understood to the student of the Bardo Thodal that these deities, as well as all other deities, encountered upon this plane are merely the illusions or hallucinations of the mind, attempting to understand the experience that is set upon them. It is exactly this belief that ultimately is to save the soul from eternal torment.

These two, God and Demon, come before the dead. The God comes with white stones to put upon the scales representing the good deeds of the person. The Demon comes with Black stones and puts them upon the scales representing the evil deeds of the person. It is explained to the dead that they will be scared during this time, nearly in a panic, and they will try desperately to justify themselves as they watch the black stones being laid out. This fear stems from the nature of the surrounding deities. For should they not pass this test and achieve illumination during this time, should they lie to the deities saying they have committed no sins, they shall be lassoed by one of the ‘executives of the lord of death’ and dragged off. The ‘executive’ then disembowels the dead with all the pain that would be produced in the body of the living. This being done, the body reconstructs itself and the moment repeats itself for an undetermined amount of time.

During the entirety of this scene, the Guru reading the text is coaching the dead on the precepts of illumination in the hopes that the person’s spirit may realize and escape the fate of being trapped in this judgment for any length of time (Evans-Wentz, 1960). The goal of this is to help the dead realize that the deities and events taking place around the consciousness of the person are indeed created out of that person’s consciousness. The dead must realize these events as illusory and that they cannot hurt the person or the spirit of the person. This process continues until the individual’s rebirth into a still more miserable life, or until illumination occurs and the individual is freed from this tormented vision of duality and enters oneness, unity or transcendence.

Taoism also holds this precept of unity. In the Hua Hu Ching translated by Hua-Ching Ni (1979), death is dealt with as a consequence of dualistic thinking more than a moment in and of itself. In Taoism, death does not rightly exist. We see death because we see life; we experience death because we experience life. Death is represented only because the universal oneness has not been realized: “Kind prince, if one still holds the divisive mental concepts of self and others, male and female, longevity and brevity, life and death, and so on without end, then one does not have an all-embracing awareness of the Universal Life” (p. 110). This is the type of realization that can be reached through actualization. This realization can aid a person in transcending the ego, transcending a dualist mindset, and ultimately aid the person in preparing for a peaceful acceptance of his or her role as the dying. Rather than fear an illusory separation, the individual may come to realize that there is ultimately nothing to separate.

Fear of death often runs much deeper than the separation from loved ones and lifetime acquisitions. It also has deep roots in the fear that one will lose the self, the knowing cognizing being that we believe to be the “I”. This is likewise dealt with in the Hua Hu Ching. In his elucidation of the original text, Hua-Ching Ni reminds the student that cognition and the contents of knowledge are of the brain cells. These things will die with the body. These things, however, are not the Self. The intuitions and character of the individual continue on after death and may be reincarnated (Ni, 1979). Intuition and character are of the one (or Tao), not the individual experiences that we experience the character and intuition through.

In looking at death as a process of dying, one begins to consider these issues of a good versus a bad death. The next step in this wondering is to ask how we may achieve a good death. Zalinski and Raspa (2006) adapted Abraham Maslow’s hierarchy of needs and the path toward actualization as one method through which we may aid the dying and perhaps eventually ourselves in the quest to achieve a good death.

Maslow’s hierarchy of needs can be looked at as a pyramid similar to that of the food pyramid, where the most basic of needs are at the bottom and actualization is at the top. At the base, physiological needs must be met. Maslow considers these to be needs in the order of food, water, and air (Maslow, 1968). Zalinski and Raspa adapted this to the need of the dying patient as being that of physical comfort, or the lack of pain. When a patient is in pain it may be difficult or even impossible for the patient to focus on anything else, disallowing safety needs to be met. Safety needs as described by Maslow include shelter from the elements and protection of the body and a security of resources. When these needs are applied to the dying, they transform slightly to include emotional safety. In this the dying should have freedom from the fear of dying (e.g. how they will die) and feel a sense of safety concerning their care (Zalinski & Raspa, 2006). Love and belonging as Zalinski and Raspa have it, is not much different from Malsow’s interpretation. For the dying this includes the love and acceptance of family members and friends as well as the care giving staff. Esteem needs are met in this schema by the dying individual’s ability to accept the new place that the individual finds himself or herself, as their role has changed. Where the dying may have been a provider or socialite in the past, they find themselves unable to perform these past social roles. This can lead individuals to feel that they are no longer worth anything. This, in combination with Emanuel’s work with the dying role, discussed later (Emanuel, Bennett & Richardson, 2007) may be beneficial as the individual learns to redefine the self and develop self esteem based on these new self-concepts. Unfortunately, Zalinski and Raspa fall short in their attempt to adapt actualization needs into the realm of the dying. While they do indicate that actualization is part and parcel of the idea of transcendence and the connection the actualized shares with the universe and other people, Zalinski and Raspa seem to miss the depth of the point that they themselves make.

With the dying being given the opportunity to climb the pyramid toward actualization, they are simultaneously given the opportunity to realize their own personal and ultimate truth. This truth can be seen as synonymous with the true Self. The individual whot has attained this moment of transcendence has effectively been prepared in mind and body for the transcendence of death. With this preparation, the individual can safely and securely enter into what perhaps can be seen as the most terrifying of journeys into the unknown. Should the dying be given this opportunity and take it wholeheartedly, the passage into death could possibly be seen as a beautiful moment of union rather than separation.

Picking up where Zalinski & Raspa left off, Smith (1995) deals extensively with the problem of death in traditional fields of psychology. She states that “traditional theories of psychology, on which some social work interventions are based, are highly ego identified in their focus and have heretofore lacked a theoretical framework for an ego-transcending phenomena such as death” (p. 403). Based on the assumption that individuals have a natural drive or “impulse” toward transcendent states, Smith (1995) argues for the use of transpersonal psychology in dealing with the death and the dying from a clinical perspective. Smith proposes a Transegoic Model through which the dying may experience the confrontation with mortality and ultimately death with a peaceful acceptance rather than fear and resistance.

The first stage of Smith’s model involves the normalization of death. Through normalization individuals can come to look at death as a natural part of the process of living rather than as an end to that living. Smith explains that the healing during this stage can take the form of dealing with the reality of ones situation rather than engaging is unrealistic wishes for health or longevity.

Emanuel Bennett & Richardson (2007) discuss this issue at length in their paper “The Dying Role”. In their paper they deal with the issues faced by the dying individual and come to the conclusion that “dying is by definition an existential matter” (p. 164). What the person is faced with can be seen as a “final growth phase” during which the individual may attempt to reconcile interpersonal relationships, finish tasks, or accomplish dreams. Ultimately however the individual will need to face dying itself and what this means concerning the beliefs of an afterlife, soul and Self. Emanuel Bennett & Richardson wisely call for caregivers to consider the needs of the dying in order for them to have a good death. In many ways this is intimately dependent on the roles that the caregivers of the dying assume. Considering the vast mosaic of spiritual beliefs and cosmologies, it may not be so much the need for medical expertise that the dying need as much as what Emanuel calls cultural and spiritual competence. For instance if the medical care continues for too long the individual may stay in the sick role, all the while hoping for a cure, rather than being allowed to begin the process of final growth in the dying role. This final growth into the dying role is paramount to the ability to have a good death, releasing oneself into a secure belief in a peaceful manner. To fight and struggle and enter death with resistance, while poetically a nice thought, is not in the end a good death. One’s last moments are, after all, one’s last moments. Remember Krishna’s words to Arjuna, “Whatever occupies the mind at the moment of death determines the destination of the dying; always they will tend toward that state of being.” (Bhagavad Gita, 8:6)

In Smith’s second stage “faith in the existential self” she points out the need for the individual to find personal meaning in life and to discover the True Self. Smith utilizes Frankl’s logotherapy in which “the patient is confronted with and reoriented to the meaning of his or her life” (p. 407). This meaning, as she points out, is highly individualistic. Of primary importance during this stage is overcoming conditioned meaning. For instance, through enculturation we may have been conditioned to believe that we are separate from our loved ones. This can cause the fear of separation from them through death. If the individual can relearn personal meaning and realize the unity of reality he or she can rest easier in a new belief, perhaps that we become closer to our loved ones through death. Tied into this philosophy of unity rather than separation, Smith draws from Assagioli’s psychosynthesis. Through this latter concept, the patient is guided to reorient personal feelings of “me” and “I” toward a type of role transcendence. Smith suggests continuing to ask the patient who they “are” until role naming (e.g. mother, father, doctor, teacher, student, etc.) has been exhausted and the patient is left with “an ‘I’ that simply is” (p. 407).

With this process fully integrated, the patient may be brought to the level of the third stage, Ego Disattachment. In this phase Smith draws from both Frankl and Assagioli while adding Maslow’s Being Cognition. Through Being Cognition the individual begins the process of integrating perception into a unified whole, realizing the oneness of existence. By continuing to dis-identify the True Self from preconceived definitions of self, the individual may begin to find a personal meaning for the process of death and death itself, as well as find peace in the realization that death does not signal a separation from the Self but may in fact signal a union with the Self (Smith, 1995).

In Smiths last stage, Self-transcendence, the patient continually works on the lower stages in the model and reaffirms the work done in those stages. As is implied by the title of this stage, the primary work in this stage is the process of letting go of the self, or the ego identification and then to ultimately redefine the self as the dead self. In this the patient will contemplate what they will be like when they are dead, what they will be doing, and what will be happening. Religion often offers patients a method through which to describe and visualize this future dead self. Being in heaven with one’s relatives or going through reincarnation can give the individual a sense that while life may be over, “being” is not. Smith cites the case of a woman who did not believe in an afterlife but was able to work through this stage within her belief that she would be a memory, and was able to spend her last days insuring that she would be a good memory to those that she loved (Smith, 1995). Eastern religions like the ones mentioned above offer much in the way of asserting the principle of ego transcendence and ultimate unity with the cosmos.
In conclusion it seems that what transpersonal psychology is offering the field of thanatology is what the religions of the East have been offering for centuries, transcendent union. The way Smith describes her stages for the patient dealing with death reads in very much the same way as the Bardo Thodal. In stage one, the Normalization of Death, we find the dead in the Bardo needing to realize that they are in fact dead. In stage two, Faith in the Existential Self, the individual “moves from a reactive stance to a proactive stance” (Smith, 1995, p.407). In the Bardo, the dead realizes the nightmarish dreams are manifestations of the illusion of dualistic being and can end the suffering of punishment for ill Karma at will. The Ego Disattachment of stage three is echoed throughout the methodologies of eastern practices. The dead in this case realize that they are no longer their body. Stage four, Self-Transcendence, in the Bardo can be seen as the moment of illumination when the individual realizes the illusory nature of individuality, and becomes absorbed into the cosmic consciousness of illumination or the Tao.
Considering the reality that we all are in fact going to die, the investigations of thanatology are vital to our functioning as holistic psychological beings. The religions of the East have given us guidance and preparation for mortality salience for centuries. We now see a synthesis of new and old techniques in the field of transpersonal psychology. Through a Transpersonal Thanatology we may learn not only how to die, but also a way to live that takes into account the entirety of the human experience, to include the inevitable end of that experience.

References

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Emanuel, L., Bennett, K., & Richardson, V.E. (2007). The dying role. Journal of Palliative Medicine, 10(1), 159-168.

Evans-Wentz, W.Y. (Ed.). (1960). The Tibetan Book of the Dead. London: Oxford University Press.

Maslow, A.H. (1968). Toward a Psychology of Being (2nd ed.). New York: D. Van Nostrand Company.

Ni, H.C. (Ed.). (1979). The Complete Works of Lao Tzu: Tao The Ching & Hua Hu Ching. Santa Monica: Seven Star Communications.

Razinsky, L. (2007). A psychoanalytic struggle with the concept of death: A new reading of Freud’s “thoughts for the times on war and death”. Psychoanalytic Review, 94(3), 355-387.

Scotton, B.W. (1996). Introduction and definition of transpersonal psychiatry. In B.W. Scotton, A.B. Chinen & J.R. Battista (Eds.), Textbook of Transpersonal Psychiatry and Psychology (pp. 3-8). New York, NY: Basic Books.

Smith, E.D. (1995). Addressing the psychospiritual distress of death as reality: A transpersonal approach. Social Work, 40(3), 402-413.

Solomon, S., Greenberg, J. & Pyszczynski, T. (1991). Terror management theory of self-esteem. In C.R. Snyder & D. Forsyth (Eds.), Handbook of Social and Clinical Psychology: The Health Perspective (pp. 21-40). New York: Pergamon Press.

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Zalenski, R.J., & Raspa, R. (2006). Maslow’s hierarchy of needs: A framework for achieving human potential in hospice. Journal of Palliative Medicine, 9(5), 1120-1127.